Kornimate/medical-research-clean huggingface dataset:
validity of palpation in detecting the site of lesion in diabetic trigger finger patients.

Conditions: Trigger Finger; Validity of Palpation

Summary: aim of the study: 1) to determine validity of palpation in detecting the site of lesion in trigger finger patients by detecting sensitivity specificity, positive and negative predictive values. hypothesis: sensitivity of t.f palpation will be ≥ 0.70 and specificity of t.f palpation will be ≥ 0.70.

trigger finger (t.f) is a disorder characterized by snapping or locking of a finger. painful popping or clicking sound is elicited by flexion and extension of the involved digit. it is a multifactorial disease . the common mechanism of triggering is that there is a mismatch of diameter between flexors tendons and the annular pulley (retinacular sheath) of the finger. a1 pulley is the most common site of pathology; hence some authors define t.f generally as a disease of a1 pulley . many case reports revealed that a2 or a3 pulley is a site of triggering . others revealed that flexor retinaculum or palmar aponeurosis is the site of pathology. in some cases, after intraoperatively surgeons release a1 pulley they found still triggering and found the triggering at other site . so clinician should examine all possible sites of affection before any topical procedures application or surgery, hence our question is in t.f patients is palpation valid in detecting the site of lesion? design and setting: the investigator propose a case control clinical trial to enroll tf patients (cases) and non tf diabetic patients (control) to detect sensitivity specificity, positive and negative predictive values for finger palpation. the study will be conducted in physical therapy outpatient clinic and radiology department at alahrar teaching hospital, zagazig, egypt. procedures: patients will be referred by orthopedist who knows inclusion and exclusion criteria, he will refer 31 cases (patients who agree to participate in this study). diabetic patients without tf (155) will by refereed from outpatient clinics (control). physical therapist will assess patients to detect site of pathology (a1, a2, a3, a4, a5, midpalm or wrist) then patients will be refereed to radiologist who will detect site of pathology by sonography.

Eligibility criteria:
inclusion criteria: 1 - diabetic patients will be included to this study if they have tf (cases) as clinically evaluated and refereed by orthopedist and diabetic patients not complaining of tf(control). exclusion criteria: 1. patients with complete locked finger. 2. ages below 18 y is . 3. patients with any other hand pathology .

Keywords: trigger finger
mri in assessing tumor size in women with ductal carcinoma in situ

Conditions: Breast Cancer

Summary: rationale: diagnostic procedures, such as mri, may help find ductal carcinoma in situ and find out how far the disease has spread. purpose: this clinical trial is studying how well mri works in assessing tumor size in women with ductal carcinoma in situ.

objectives: primary * assess the contribution of mri in accurately determining tumor size in women with ductal breast carcinoma in situ (dcis). secondary * evaluate the sensitivity of mri in detecting dcis. * evaluate the contribution of mammography in accurately determining tumor size. * compare the contribution of mri vs mammography in assessing tumor extension. * compare the contribution of mri vs mammography in assessing dense breasts. * evaluate the morphology of dcis by mri. * evaluate the curve of dynamic mri in assessing dcis. * evaluate the impact of nuclear grade of dcis by mri. * evaluate the rate of revision surgery. outline: patients undergo clinical examination, mammography, ultrasound imaging, unilateral breast mri, and tissue sampling.

Eligibility criteria:
disease characteristics: * diagnosis of ductal breast carcinoma in situ * any grade disease allowed * unifocal disease by mammography * no history of breast cancer * hormone receptor status not specified patient characteristics: * menopausal status not specified * who performance status 0-2 * glomerular filtration rate ≥ 30 ml/min * not pregnant or nursing * fertile patients must use effective contraception * no allergy or contraindication to contrast mri * no pacemaker or vascular clip prior concurrent therapy: * no prior or concurrent liver transplantation

Keywords: ductal breast carcinoma in situ
short term intermittent fasting and mediterranean diet

Conditions: Overweight; Pre-hypertension; Hypertension; Hypercholesterolemia; Glucose Intolerance

Summary: the purpose of this research study is to evaluate the effects of intermittent fasting in subjects that are eating a mediterranean diet or a western diet. this study is part of ongoing research in the prevention and treatment of age-related diseases at washington university school of medicine.

the primary objective of this study is to determine whether or not if, independently of changes in quality of diet, reduces the level of chronic inflammation as evidenced by a decrease in high sensitivity c-reactive protein (hscrp), as the main outcome measure.

Eligibility criteria:
inclusion criteria: 1. - the participants in this study will be 50 men and women in the 30 to 65 year age range, who have a bmi in the high-normal to moderately overweight range (i.e. 22 to 28 kg/m2), 2. - participants who are eating usual us diets and are sedentary to moderately active (i.e. not exercise trained). 3. - participants have at least one of these metabolic abnormalities: pre-hypertension or hypertension (i.e. systolic blood pressure \> 120 mmhg or diastolic blood pressure \> 80 mmhg or specific treatment of previously diagnosed hypertension)10, sub-optimal lipid levels (i.e. ldl-cholesterol \> 100 mg/dl or hdl-cholesterol \ 100 mg/dl or 2 hr-glucose during ogtt with a glucose load of 75 g \> 140 mg/dl or specific treatment for previously diagnosed type 2 diabetes)12, or high-risk waist circumference (≥ 94 cm in men and ≥ 80 cm in women)13. exclusion criteria: - 1 - history of any chronic disease process that could interfere with interpretation of results 2 - smoking, pregnancy, alcoholism, psychiatric problems, life situations that would interfere with study participation and compliance. 3 - currently eating diet similar to mediterranean diet based on dietary and food frequency questionnaires and 4-day food diary.

Keywords: intermittent fasting mediterranean diet overweight calorie restriction
comparison of the effectiveness of preemptive paracetamol and ibuprofen in acute postoperative pain

Conditions: Acute Pain; Postoperative Pain

Summary: this study will evaluate two different analgesic regimen used for acute postoperative pain.

laparoscopic cholecystectomy is a type of surgery that causes moderate postoperative pain. paracetamol and non-steroid anti-inflammatory analgesics plus opioids are the mainstay treatment options of the moderate postoperative pain. these drugs are the most common used analgesics to ameliorate this type of pain and to reduce the consumption of opioids and their side effects. ibuprofen is a well-known anti-inflammatory drug and has been used as an oral formula for a long time. few studies using its new intravenous formula had been conducted to evaluate its effectiveness for mixed type of surgeries . however, its intravenous formula has not been studied for laparoscopic cholecystectomy. therefore, this study will compare the effects of postoperative analgesic potencies of preemptive intravenous paracetamol and ibuprofen in patients undergoing laparoscopic cholecystectomy.

Eligibility criteria:
inclusion criteria: 1. american society of anesthesiologist functional status 1-2 2. body mass index smaller than 30 3. undergoing laparoscopic cholecystectomy 4. age between 18-60 years exclusion criteria: 1. age under 18, above 60 2. weight under 40 kg 3. body mass index above 30 4. contraindication for opioid and non-steroid anti-inflammatory drug usage 5. allergy against paracetamol, opioids and anti-inflammatory drugs 6. peptic ulcer 7. tendency to bleeding 8. pregnancy or breast feeding 9. moderate or severe renal, hepatic or cardiac insufficiency 10. coronary artery disease 11. asthma

Keywords: ibuprofen paracetamol laparoscopic cholecystectomy morphine visual analog scale
lung ultrasound, cholecystectomy, atelectasis

Conditions: Laparoscopic Cholecystectomy

Summary: atelectasis is an important complication that can be seen during general anesthesia, especially in patients with lung problems and in patients having pneumoperitoneum. application of peep during anesthesia may reduce the incidence of atelectasis.lung ultrasonography is a tool that is easily accessible, can be applied at the bedside, is non-invasive, does not cause radiation exposure, and is increasingly used in daily practice in operating rooms. in this study, it was aimed to evaluate the occurrence of atelectasis by using lung ultrasound, and to investigate the effectiveness of ultrasound in determining the risk of developing atelectasis in patients ventilated with different peep values during general anesthesia. the study was conducted in 60 patients aged 18 and over, from asa i-iii groups, who were planned to undergo laparoscopic cholecystectomy surgery at the istanbul medeniyet university göztepe training and research hospital general surgery clinic, and their written and verbal informed consents were obtained. the patients included in the study were divided into 2 groups. among the patients who were going to be operated, 5 peep were applied to group i (n=30) cases, and 10 peep to group ii (n=30) cases during ventilation with anesthesia device. all patients were evaluated by transthoracic lung ultrasonography before anesthetic induction, after tracheal intubation, after pneumoperitoneum, and 15 minutes after recovery from anesthesia. according to the lung usg protocol, a total of 6 regions, including 2 quadrants of each hemi-thorax anterior wall, 2 right and left lateral walls, and 2 quadrants of the posterior wall, a total of 12 regions in each patient were scanned, and the images were evaluated. according to the modified lung usg scoring system, each region was scored between 0-3 consistent with the degree of atelectasis. the total score was calculated for each patient. hemodynamic follow-up of the patients was performed. anesthesia times, surgery times, and pneumoperitoneum times were recorded and compared.


Eligibility criteria:
inclusion criteria: * patients are aged 18 and over, from asa i-iii groups, who were planned to undergo laparoscopic cholecystectomy surgery exclusion criteria: * patients who do not give consent * patients who have previously undergone thoracic surgery * patients with a body mass index \> 40 kg/m² * patients with severe copd * patients with serious pulmonary diseases * patients diagnosed with obstructive sleep apnea syndrome * asa iv patients * patients with advanced cardiac and neurological diseases * patients with mental retardation and limited cooperation * patients who terminate their participation in the study for any reason during the trial * pediatric age group pregnant women

Keywords: general anesthesia, lung ultrasonography, peep, pneumoperitoneum, atelectasis
the epoch study (eplerenone on top of ace inhibition in chronic kidney disease patients with hypertension)

Conditions: CKD II-III

Summary: in a prospective single centre placebo-controlled trial over ten weeks, 24 ckd ii-iii patients (egfr 30-89 ml/min per 1.73 m2) with dm ii will be randomized to enalapril 20mg per day after a two week run-in phase. thereafter, patients will either receive eplerenone 25mg (n=12) or a placebo (n=12) for eight weeks. eplerenone will be increased to 50mg under close monitoring of serum potassium levels. employing a novel mass-spectrometry ( ms)-based method, quantification of up to 10 different ang metabolites (ang i, ang ii, ang 1-7, ang 1-9, ang 2-10, ang 1-5, ang 2-7, ang 3-7, ang 3-8 and ang 2-8) will be performed simultaneously out of blood sera (after run-in phase and after 10 weeks).


Eligibility criteria:
inclusion criteria: * ckd ii to iii and diabetes mellitus type 2 * ckd will be defined according to estimated glomerular filtration rate (egfr) with the mdrd formula * egfr between 30 and 89 ml/min * albumin excretion rates \> 300 mg/24 hours (uacr \> 300 mg/gram) or \> 200 mg/g if already receiving any ras blockade patients should be hypertonic stage i or ii according to the european guidelines (chobanian et al. jama 2003) exclusion criteria: * age \< 18 years * uacr \> 3500mg/g * severe hypertension * pregnancy * unwilling or inability to sign the informed consent * coronary heart disease * systolic blood pressure \< 130 mmhg * additional ras interfering drugs (aceis, arbs, direct renin inhibitors) * 25-hydroxy vitamin d levels below 16.6±8.3 pg/ml * 1,25-dihydroxy vitamin d 33.1±15.5 pg/ml intolerance to eplerenon or an excipient of it: tablettcore: lactose-monohydrat mikrokristalline cellulose (e 460) croscarmellose-sodium (e 468) hypromellose (e 464) sodiumdodecylsulfat talkum (e 553b) magnesiumstearat (e 470b) filmcoat opadry, yellow: hypromellose (e 464) titandioxid (e 171) macrogol 400 polysorbat 80 (e 433) yellow ironoxide (e 172) red ironoxide (e 172) * patients with serumpotassium \> 5,0 mmol/l at start of the treatment * patients with severe renal insufficiency (egfr \<30ml/min./1.73 m2) * patients with severe liver insufficiency (child-pugh class c) * patients taking potassium saving diuretics, potassium supplements or strong cyp3a4-inhibitors (z. b. itraconazol, ketoconazol, ritonavir, nelfinavir, clarithromycin, telithromycin und nefazodon)
droplet digital pcr and pcr-free biosensors for the detection of resistance-associated snps in pneumocystis jirovecii

Conditions: Pneumocystis Pneumonia

Summary: the main objective of the proposed research is to identify pneumocystis jirovecii mutant strains on 4 genes encoding therapeutic targets such as dihydropteroate synthase (dhps), dihydrofolate reductase (dhfr), cytochrome b (cyb), inosine-5'-monophosphate dehydrogenase (impdh) and therefore to assess the prevalence of potentially resistant strains in patients infected with p. jirovecii.

pneumocystis jirovecii (p. jirovecii) is an opportunistic pathogenic fungus responsible for pulmonary infection or pneumocystis pneumonia (pcp) in immunocompromised patients. there is currently no system for its in vitro culture. the diagnostic methods used are mainly based on molecular biology techniques which also allow the detection and analysis of single nucleotide polymorphisms (snps), particularly at the level of genes coding for the targets of molecules widely used in the prevention and treatment of pcp. these snps may represent missense mutations potentially associated with treatment resistance. they may result from exposure of patients to these treatments before the development of p. jirovecii infection. however, data concerning the prevalence of these mutations remains scarce, particularly in france. methods for detecting these mutations based on pcr followed by dna sequencing have limitations in terms of sensitivity. the evaluation of new, more sensitive and rapid tools for the detection and characterization of pathogens in this context is necessary. the main objective of the proposed research is to identify p. jirovecii mutant strains on 4 genes encoding therapeutic targets such as dihydropteroate synthase (dhps), dihydrofolate reductase (dhfr), cytochrome b (cyb), inosine-5'-monophosphate dehydrogenase (impdh) and therefore to assess the prevalence of potentially resistant strains in patients infected with p. jirovecii. the secondary objectives are: * to determine the factors associated (e.g. exposure to treatments) with mutant p. jirovecii strains * to determine the impact of mutations on the effectiveness of anti-pneumocystis treatment (e.g. favorable vs. unfavorable evolution of the infection) * to evaluate two methods - digital droplet pcr and biosensors without pcr - for the detection and characterization of mutations associated with resistance in pneumocystis jirovecii

Eligibility criteria:
inclusion criteria: * patients in whom p. jirovecii was detected in a pulmonary sample (bronchoalveolar lavage, sputum, bronchial aspiration, oropharyngeal rinse, nasopharyngeal sample) * no opposition * patient affiliated to a social security system exclusion criteria: * patients under legal protection (guardianship, curatorship) * refusal to participate

Keywords: pneumocystis jirovecii mutant anti-microbial resistance dhps dhfr cytochrome b impdh
the influence of treatment position (prone vs. supine) on whole breast target

Conditions: Breast Cancer

Summary: radiotherapy after breast conserving therapy plays an important role in early stage breast cancer patients. it not only results in a reduction in local and regional recurrence but also decrease the death rate effectively. for adjuvant radiotherapy, supine positioning is the most common approach and has multiple advantages. due to deformability and softness of the breast, during simulation and treatment in supine position, the breast stretches over the chest wall, especially in patients with large and pendulous glands. thus the organs at risk (oars) received dose increased. the radiotherapeutic toxicity are unavoidable. some present studies show that the prone positioning of patients can improve dose homogeneity and reduce the dose distribution in oars in patients with large and pendulous glands. chinese women have relatively small breasts, the advantages of those have not been established. therefore, investigators compared the parameters between supine and prone positions for whole breast irradiation after conserving surgery.

objective to investigate the difference of target volumes and dosimetric parameters between supine and prone positions for whole breast irradiation after conserving surgery. methods breast cancer patients with t1-2n0m0 stage who underwent radiation therapy after conserving surgery were enrolled. supine and prone scan sets were acquired during free breathing for all patients. target volumes and organs at risk (oars) including heart, ipsilateral lung and bilateral breast were contoured by the same radiation oncologist. the tumor bed (tb) was determined based on surgical clips. the clinical target volume (ctv)consisted of the whole breast. the planning target volume (ptv) was ctv plus 0.5cm. the boost of ptv (ptvboost) was tb plus 0.5cm. dosimetric parameters of target volumes and oars were compared between supine and prone position.

Eligibility criteria:
inclusion criteria: 1. breast cancer patients with t1-t2n0m0 stage who underwent radiation therapy after conserving surgery 2. exhibited normal arm movement aſter surgery 3. had no chronic lung diseases 4. written informed consent forms exclusion criteria: 1. breast cancer patients with radical surgery 2. could not exhibit normal arm movement after surgery 3. had chronic lung diseases 4. refused informed consent forms

Keywords: breast cancer radiotherapy
the naples pediatric food allergy (napfa) score

Conditions: Food Allergy in Children

Summary: food allergy (fa) is one of the most expensive allergic disorders in the pediatric age, and affecting up to 10% of children worldwide, it is recognized as a global health problem. the oral food challenge (ofc) is the gold standard for fa diagnosis, but it is time-consuming, expensive, and potentially dangerous, as it can determine severe anaphylaxis. in addition, causing long-lasting impact on patient anxiety and mental health due to the physical duress and health risks involved with its application, ofc strategy is little applied in clinical practice with consequent diagnostic errors and delays. the goal of the naples pediatric food allergy (napfa) score is to develop a new clinical score including the main anamnestic, and clinical features for the easy identification of pediatric fa in primary care setting.


Eligibility criteria:
inclusion criteria: * subjects aged between 0-14 years with suggestive history of food allergy exclusion criteria: * exclusion criteria: age \>14 years * chronic systemic diseases, * malignancy, * immunodeficiency, * infectious diseases, * autoimmune diseases, * inflammatory bowel diseases, * celiac disease, * metabolic and genetic diseases, * cystic fibrosis, * chronic pulmonary diseases, * gastrointestinal, respiratory, urinary tract and/or cardiovascular malformations, * neurologic and/or neuropsychiatric disorders, * gastrointestinal tract eosinophilic disorders, * use of immunomodulating drugs in the previous 4 months * use of steroids and antihistamines in the previous 2 weeks

Keywords: food allergy
a study of bgb-r046 as monotherapy and in combination with tislelizumab in solid tumors

Conditions: Solid Tumor

Summary: this is a first-in-human (fih) study that will evaluate the safety, tolerability, pharmacokinetics (pk), pharmacodynamics, and preliminary antitumor activity of bgb-r046 as a single agent and in combination with tislelizumab (bgb-a317) in participants with advanced or metastatic immune-sensitive solid tumors.


Eligibility criteria:
inclusion criteria: * participants able to provide a signed and dated written informed consent prior to any study-specific procedures, sampling, or data collection * participants with histologically or cytologically confirmed advanced, metastatic, and unresectable solid tumors who have previously received standard systemic therapy or for whom standard treatment is not available, not tolerated, or determined not appropriate based on the investigator's judgement * ≥ 1 measurable lesion per recist v1.1 * able to provide an archived tumor tissue sample * eastern cooperative oncology group (ecog) performance status ≤ 1 * adequate organ function * life expectancy \>12 weeks as determined by the investigator exclusion criteria: * active leptomeningeal disease or uncontrolled, untreated brain metastasis * active autoimmune diseases or history of autoimmune diseases that may relapse * any malignancy ≤ 3 years before the first dose of study drug(s) except for the specific cancer under investigation in this study and any locally recurring cancer that has been treated with curative intent (eg, resected basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix or breast) * any condition that required systemic treatment with either corticosteroids (\> 10 mg daily of prednisone or equivalent) or other immunosuppressive medication ≤ 14 days before the first dose of study drug(s) * history of interstitial lung disease, noninfectious pneumonitis (including immune mediated), or uncontrolled lung diseases including pulmonary fibrosis, or acute lung diseases. * experienced ≥ grade 3 imae(s) on prior immuno-oncology agent (anti-pd-1, anti ctla4, or other experimental drugs) * uncontrolled diabetes \> grade 1 laboratory test abnormalities in potassium, sodium, or corrected calcium despite standard medical management, or ≥ grade 3 hypoalbuminemia ≤ 14 days before the first dose of study drug(s). * infection (including tuberculosis infection, or other) requiring systemic (oral or intravenous) antibacterial, antifungal, or antiviral therapy ≤ 14 days before the first dose of study drug(s) * immunodeficiency as assessed by the investigator to be not suitable for treatment with immune modulating anticancer agents note: other protocol defined inclusion/exclusion criteria may apply.

Keywords: bgb-r046 first-in-human advanced solid tumor anti-programmed death-1 (anti-pd1)